TNF and acute lung injury: Abnormal partial oxygen pressure promotes the release of tumor necrosis factor-alpha and IL-1 beta, which are inflammatory cytokines that mediate lung lesions.21 According to Mascia et al.19 and Botha et al.,6 30–45% of potential donors develop lung injury, with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) being the most frequent.